Maternal Mental Health Matters

January 23, 2020

Young woman sitting on floor expressing sad feelings and emotions

Mental health. There are awareness days, weeks, and months. Every year in January, all across Canada people participate in Bell Let's Talk to support mental health initiatives. Slowly, we as a society are shedding some of the stigma around mental health.

Unfortunately, maternal mental health has not always had the recognition, despite the prevalence of antenatal mood disorders.

But things are changing. These days, it is more common to hear conversations about postpartum depression (PPD). More providers are asking the right questions, paediatricians and family doctors are also asking screening questions of new parents. There are more organizations dedicated to helping new parents adjust.

We aren't saying the stigma is gone (it's not), or that these conversations are unimportant. They are SO important. But there is more to the story than PPD, and sometimes, other maternal mental health matters get lost in the shuffle. One that is often ignored is antenatal depression.

Antenatal Depression

Being depressed while you are pregnant is not a topic that is discussed with most pregnant people. It is rare to see depression screenings done during a pregnancy unless either the parent raises it on their own or they have a history of mental health concerns.

Between 7% and 20% of pregnant people will experience some level of diagnosable antenatal depression. The stress and toll that depression can cause in the body can have impacts on the health of the pregnancy and the baby. Antenatal depression can result in preeclampsia, premature birth, and low birth weight. And, it is a significant risk factor for postpartum depression. Typically, when the depression begins in pregnancy, the symptoms are more severe postpartum.

Risk Factors

Although depression can affect anyone at any time, there are several risk factors that make prenatal depression more likely:

unplanned pregnancy

difficulty becoming pregnant

history of loss

financial and/or housing insecurity

domestic abuse

job stress

social isolation

social/family pressures

Although prenatal depression is as common as 20% of pregnant people, it is a conversation we like to avoid having as a society. We want to believe that pregnancy is a happy, joyful time for everyone. But it isn’t always, and it is not a moral or personal failing if you are suffering from depression.

It does not mean you love your baby less.

We want to say that again – being depressed during your pregnancy does not mean you love your baby any less.

But you also don’t have to suffer. Nor are you alone.

There are resources available for people who are experiencing any antenatal mood disorder. The first person you should connect with if you are struggling is your prenatal care provider (whether your OB, a family doctor, or a midwife). They should be able to refer you to the appropriate program for your area or hospital. Be prepared to wait, many of these programs have waitlists, but it is better to get on them early so you can get help.

Resources

While you are waiting for a maternal mental health program space, there are other community resources that can be of help.

Talk therapy: finding a private therapist in the community, especially one who has pre- and post-natal experience can be incredibly helpful. If you aren’t sure where to start to find a therapist, many workplaces have an Employee Assistance Plan that can point you in the right direction. Parenting groups can also be an excellent source of recommendations, as can your doula!

Lifestyle changes: although these will not alleviate any anxiety or depression, it can relieve other stresses in your life. This might mean more consistent childcare for older children, going on short-term disability and ending work earlier, working from home, or something else that makes sense for your family

Alternative treatments: many people find that diet changes, acupuncture, touch therapies, or other options help with their symptoms. This can be a game of trial and error to find out what works best for you.

Medications: Although it can seem controversial, there are medications that have been found to be safe in pregnancy. While it is true that, like anything else, there are risks it is only prescribed when the benefits of medication outweigh the risks. This is a treatment path that will be done in consultation with your pregnancy care provider and, usually, a psychiatrist.

Let's Open the Conversation

When we don’t talk about something, it becomes the elephant in the room. And eventually, elephants become dangerous. Over the past few years, we have seen more and more people coming forward and being open about their struggles during pregnancy. This is so important because only when it is out in the open can we begin to address the problem.